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Industrial 
pie 

D o u c: L 

The Journal of tin 


Training for 
:s in Russia 


Crip- 
iE 

Association 


A S C. M c M U R T Px 

NEW YORK 


Reprinted from 
Missouri State Medical 
December, 1912 






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INDUSTRIAL TRAINING FOR CRIPPLES 
IN RUSSIA 

Douglas C. McMurtrie 

NEW YORK 

The care of cripples in Bussia has received but 
scant attention and throughout the empire there 
are but few agencies devoted to the improvement 
of their condition. In St. Petersburg there is 
one institution, however, which has carried the 
industrial training of cripples to a point which 
renders it almost unique. It prepares even the 
most seriously handicapped cripples for a useful 
occupation, and from this viewpoint its work 
cannot fail to be of interest to those identified 
with similar efforts in other parts of the world. 

The need of the crippled and deformed for 
some kind of systematic training was strongly 
impressed on Prof. N. A. Welliaminoff, surgeon 
to the Czar, and head of the great Maxmilian 
Hospital at St. Petersburg. In casting about for 
some trade in which instruction might he given, 
the manufacture of orthopedic apparatus ap- 
peared to offer exceptional promise. This also 
was recommended by a double advantage; while 
some cripples were being benefited by the train- 
ing for an occupation, other cripples were pro- 
vided at the same time through the lowered cost 
and improved quality of the appliances required 
by their deformity. The approval of the Directors 
of the Maxmilian Hospital was secured and an 
orthopedic workshop for trade training of cripples 
was opened Oct. 14, 1897, under the patronage of 
Princess Eugenie. The shop is affiliated with 



the orthopedic department of the Maxmilian 
Hospital. 

From the start the physicians identified with 
the hospital took a great interest in the project 
and up to the present time have provided for its 
support by obtaining contributions from the 
nobility. During the first year the workshop was 
quartered in a suite of three rooms in the hospital 
building. At the present time it occupies four- 
teen rooms on one of the lower floors of the same 
building. At first there were but two pupils, and 
during the first few years instruction during the 
day only was provided without resident accom- 
modation. Preference regarding admission was 
given to young cripples. A teacher who had been 
trained in the school for cripples at Helsingfors, 
Finland, was secured, and as branch subjects she 
gave instruction in cabinet making, spinning, 
weaving and brush making. The work on orth- 
opedic apparatus was supervised by the physician 
in charge of the workshop. At first the produc- 
tion of appliances was very naturally limited to 
v simple apparatus, but during the course of the 
first two years thirty-eight patients of the hos- 
pital received their orthopedic braces free. It 
was difficult, however, to meet the requirements 
in the matter of special shoes and complicated 
metal appliances, and as a result in 1899, a 
special shoe-making department was installed and 
placed in charge of a specialist. In 1900, the 
necessary lathes and machine tools were acquired, 
a forge was erected and a machinist and appar- 
atus maker were employed. 

But up to this point it had been impossible to 
provide for the very seriously maimed cripples, 
as, for instance, the one-armed and the armless, 
the teachers in the workshop not being acquainted 






with the methods of instruction for persons so 
deformed. There was no suitable teacher in 
Eussia, and the institution at Copenhagen, Den- 
mark, had but three available teachers, none of 
whom they could spare. The oldest pupil at the 
St. Petersburg workshop, P. N*. Alexandrow, was 
therefore sent to the Copenhagen school to learn 
the methods there in vogue. Completing his 
course in 1903, he returned to his own institution 
and was appointed teacher in the workshop, 
remaining there up to the present time. This 
brought about a considerable improvement, but 
there was still need for the use of apparatus in 
certain processes which would lessen the labor 
involved. In order to make the mechanical part 
of the work as perfect as possible, there was there- 
fore added to the staff of the workshop a key- 
maker, W. G. Sorokoumow, who was himself a 
cripple. 

In 1904, the war in which Eussia was engaged 
with Japan caused an augmented demand for 
orthopedic appliances, and the workshop was con- 
siderably enlarged. 

It was found that transportation to and from 
the workshop each day was a serious problem for 
some of the cripples, and there was therefore 
founded in 1901 the "Association for the Care of 
Cripples Learning a Trade." The object of this 
organization was to provide a resident home in 
conjunction with the workshop, and to provide 
the additional care necessary to train the cripples 
for careers as industrious workers and useful 
members of the community. 

Cripples between the ages of 14 and 30 are 
received for instruction at the workshop. The 
term of instruction for those with reasonable 
capacity for work averages about four years. At 



the expiration of this time if the cripple is in a 
position to do independent work, even though this 
work might necessarily be extremely simple, three 
alternatives are considered : Either he remains in 
the workshop and receives wages, or remains in 
the workshop and is partly paid for his labor, or 
he receives a recommendation and is employed 
in a private shop. 

Some of the cripples are, of course, so severely 
handicapped that they can be assigned no fixed 
period of training. Such • pupils receive a certain 
amount for their work, even during the course of 
their instruction. Those who work hard and 
make satisfactory progress receive every month 
between two and five rubles 1 for clothing. The 
object of these payments is to accustom them to 
rely for support on the money which they them- 
selves earn and not to get them in the habit of 
depending exclusively on charity. 

The more able workers go into the orthopedic 
department of the hospital. After four years of 
training they receive wages of between twelve and 
fifteen rubles a month. Such pupils not only 
clothe themselves at their own expense, but also 
pay three rubles a month for their room in the 
home, or else rent quarters near the workshop. 

During the first ten years of its existence the 
workshop received 116 men and 11 women. Of 
these there have been discharged 74 men and 3 
women. All further analysis will be made on the 
basis of this first ten year period. 

The cripples admitted are divided into three 
classes according to the degree of loss of working 
powers. To the first class belong those afflicted 
with serious loss, such as amputation of both 
arms, or the complete crippling of them; or 

1. A ruble is equivalent to approximately 50 cents. 



amputation or crippling of one arm, especially 
the right, and particularly in the case of such 
sufferers as have no personal talent for handi- 
craft; or the loss of several fingers. Among the 
pupils in the workshop, twenty have been in this 
class. 

In the second class are cripples with injuries 
to the body or the limbs, those suffering from 
some progressive disease; and those who have 
recovered from a serious wound. In such cases* 
outside assistance and the general conditions of 
work are of the greatest importance. Excessive 
exertion would be injurious and tend to aggravate 
their crippled condition. There have been thirty- 
four of this class in the workshop. 

To the third class belong cripples with ampu- 
tated lower limbs and deformity of the limbs, 
whether congenital, rachitic or due to other 
causes. The ability of cripples of this class to 
work is limited by the difficulty of their power of 
locomotion, and is thus largely dependent on the 
usefulness of artificial limbs and the correct 
choice of occupation. There have been twenty- 
five of this class in the workshop. 

The following table gives a survey of the occu- 
pations taught the cripple, together with a state- 
ment of the number trained in each trade. 

Trade Workers trained 

Orthopedic apparatus 16 

Key-making . . -. 33 

Ordinary shoemaking 38 

Cabinet-making 12 

Turning 3 

Brush-making 2 

Basket-making 4 

Weaving and sewing 4 

Saddlery 3 

Tailoring 12 



The following statement will show the results 
of the training of those that have been dis- 
charged : 

Twelve engage independently in the occupation 
taught them in the workshop. One woman 
teaches manual trainings one works in the shop 
of an orthopedic institute, six work in private 
shops, four in their own villages, five ar$ em- 
ployed in various mon-mechanical occupations, 
one is a porter, one is an accountant, two are 
domestic servants, one is a hostler, three have 
learned specialties not taught in the workshop 
and are now working independently for them- 
selves (two girls as ironers and one in dental 
work), thirteen men have disappeared, three were 
taken home by their relatives, and seven refused 
to work. 

There are at present in the workshop three 
teachers at a salary of 30 to 75 rubles a month. 
Pour instructors work part time earning from 
10 to 25 rubles a month; -seven are assistants of 
the masters; one woman assists the inspectress, 
and one man acts as secretary earning from 10 
to 20 rubles a month. There are twelve older 
pupils and ten younger ones and two are in ser- 
vice in a private house. 

Quite a number of the pupils have been dis- 
abled soldiers. Excluding these there were sixty- 
six men who had completed the course of instruc- 
tion. Of these, twenty have gone outside and 
become good workmen, and twenty-eight are em- 
ployed in the workshop. This shows 72 per cent, 
of the cripples as able to work after proper train- 
ing. The outside workers, or 30 per cent, of the 
total, labor satisfactorily under normal conditions 
of industry. Those within the workshop, or 42 
per cent, of the total, work under preferentially 



favorable conditions. Among these latter are the 
cripples of the first and second classes to which 
reference has already been made, whose ability to 
work is largely dependent on their environment. 
In the St. Petersburg shop the workers are pro- 
tected from over-exertion. They work seven and 
one-half hours a day and have an intermission of 
three hours at noon. During the summer the 
pupils have the regular workman's vacation and 
the "Association for the Care of Cripples Learn- 
ing a Trade" provides a stay in the country. 

During the period we are analyzing, the work- 
shop produced 7,785 pieces of orthopedic appar- 
atus, in addition to 1,976 non-orthopedic articles. 
Of the orthopedic appliances, 804 were given to 
various philanthropic agencies at a third or a half 
of their value. Assistance was thus rendered to 
611 cripples. The expenses for a recent year 
were, in round figures, 95,000 rubles, while the 
income of the workshop was 92,000 rubles, not 
including rent, light or heat. It will thus be 
seen that the cost was very low, especially in view 
of the fact that industrial training for graduated 
pupils is included in the account. 

The experience of this Eussian institution has 
been duplicated in several other place's. The 
great institution for cripples at Copenhagen 
found that while some of its graduates might be 
successful in commercial competition with nor- 
mal workers, many by reason of serious handicap 
required special conditions of work. Perhaps the 
need was for apparatus adapted to their defici- 
ency, perhaps for adjustable chairs or stools, per- 
haps for a rest period in the middle of the day. 
It has been found in England, Belgium and 
France as well as in Denmark and Bussia that 
the prime purpose can be best attained by a spe- 



8 

cial workshop inaugurated by philanthropic ini- 
tiative and subsidy., but maintained on a thor- 
oughly self-supporting or profitable basis. 

There is need at the present time for more 
workshops of this character. Their value is un- 
questioned from both the humanitarian and 
economic standpoints. They make helpless crip- 
ples into self-respecting members of the com- 
munity and burdens on society into productive 
workers. 

298 Metropolitan Tower. 



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